Abstract
Ischemic necrosis of the bulbar urethra after perineal urethroplasty can lead to complex, long-segment strictures. Traditional approaches often involve vascular reconstruction followed by transpubic urethroplasty. A 20-year-old man presented with a posterior urethral injury resulting in urethral distraction following a road traffic accident. He underwent anastomotic urethroplasty 10 months later, which then failed. We employed ascending colon substitution urethroplasty to manage a case of ischemic bulbar necrosis, offering an alternative to tubed flap or staged grafting procedures.